title: Patient satisfaction with the general practitioner: a two-level analysis.
abstract: OBJECTIVE
  The authors examine how patient satisfaction with health care providers relates to either the individual characteristics of respondents or the characteristics of health care providers and the structural setting in which they work.
  
  
  METHODS
  Measures of three dimensions of patient satisfaction with the general practitioner (GP)--accessibility, interpersonal relationship, information given--were derived from an existing data set. Patients were nested with GPs. Multilevel analysis was used as the analyzing technique.
  
  
  RESULTS
  Between 90% and 95% of the variance in patient satisfaction scores is at the patient level, whereas the remaining 5% to 10% is at the GP or practice level. At the patient level, in addition to the usual predictor variables such as age and morbidity, which explain approximately 5% of the variance at this level, previous experiences with the general practitioner in the form of misunderstandings or incidents may play an important role in the emergence of dissatisfaction among patients.
  
  
  CONCLUSIONS
  This study demonstrated the usefulness of multilevel analysis in studying patient satisfaction scores. Findings indicate that the effectiveness of strategies directed at health care providers or services and aiming to improve the quality of care through the patient's eyes can be questioned when these strategies are based on general satisfaction scores only. More attention should be paid to the interaction process between patient and GP.
authors.affiliation: NIVEL--Netherlands Institute of Primary Health Care, Utrecht.
authors.forename: H J
authors.initials: HJ
authors.lastname: Sixma
authors.forename: P M
authors.initials: PM
authors.lastname: Spreeuwenberg
authors.forename: M A
authors.initials: MA
authors.lastname: van der Pasch
mesh_terms: D000328:Adult; D000368:Aged; D005194:Family Practice / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009426:Netherlands; D010353:Patient Education as Topic; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000592:standards / Q000706:statistics & numerical data